Persistence of single echo beat inducibility after selective ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia: relationship to the functional properties of the atrioventricular node and clinical implications
Articolo
Data di Pubblicazione:
1996
Citazione:
Persistence of single echo beat inducibility after selective ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia: relationship to the functional properties of the atrioventricular node and clinical implications / C. Tondo, P.D. Bella, C. C, S. Riva. - In: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY. - ISSN 1045-3873. - 7:8(1996 Aug), pp. 689-696.
Abstract:
Residual Slow Pathway Conduction Effects on AVN Function. Introduction: Residual slow pathway conduction with or without reentrant echo beats has been reported in 25% to 30% of patients undergoing ablation for AV nodal reentrant tachycardia (AVNRT),
Methods and Results: Fifty-eight consecutive patients (aged 45 +/- 12 years) with slow-fast AVNRT underwent radiofrequency catheter ablation of the slow AV nodal pathway (SP), Residual slow-fast echo beat was documented in 21 (36%) of 58 patients (group A), The pre- and postablation AH intervals triggering the echo beats were similar (346 +/- 8 msec vs 352 +/- 6 msec, P = NS), as were the pre- and postablation echo zones (55 +/- 6 msec vs 52 +/- 5 msec, P = NS) and functional refractory period of the SP, A consistent prolongation of the AV nodal effective refractory period (AVN-ERP; from 265 +/- 28 msec to 340 +/- 50 msec, P < 0.001) and the Wenckebach cycle length (WBCL; from 298 +/- 41 msec to 438 +/- 43 msec, P < 0.001) was observed in all patients with abolition of SP conduction (group B), In group A patients, the prolongation of WBCL was less (285 +/- 33 msec preablation, and 334 +/- 41 msec postablation, P < 0.001). Additional pulses abolished the residual echo in 16 of 21 patients, and further prolongation of the AVN-ERP and WBCL comparable to those found in patients without a residual echo beat was observed, During 19 +/- 8 months follow-up, no patient had clinical recurrence of AVNRT.
Conclusion: Residual single echo beat after SP ablation for AVNRT reflects the persistence of some portion of the SP with unchanged functional conduction properties whose prognostic significance is uncertain, A consistent increase of WBCL can be a reliable marker of complete abolition of slow pathway conduction and termination of AVNRT.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Adult; Aged; Atrioventricular Node; Female; Humans; Male; Middle Aged; Tachycardia, Atrioventricular Nodal Reentry; Catheter Ablation
Elenco autori:
C. Tondo, P.D. Bella, C. C, S. Riva
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